Mental Health at the Forefront During COVID-19 Pandemic

In an American Psychiatric Association virtual session, Joshua C. Morganstein, MD, stresses routine sleep and exercise is critical for frontline medical workers.

Joshua Morganstein, MD

The coronavirus disease 2019 (COVID-19) has gotten virtually everyone out of their routine, from the general workforce to children to frontline medical workers.

That abrupt disruption can be extremely detrimental for an individual’s mental health.

In a virtual presentation as part of the American Psychiatric Association (APA) Spring Highlights Meeting 2020, Joshua C. Morganstein, MD, chair of the committee on the Psychiatric Dimension of Disaster at APA, explained just how a disaster can impact someone’s mental health, leading to a number of negative outcomes.

“Insomnia and substance abuse are common and adversely impact functional and occupationally functioning,” he said. “It’s important to consider whether or not someone has alcohol use abuse disorder the increase with effects of errors and family conflicts. These are important issues for organizations and healthcare and all of our society.”

Morganstein explained that when distress reactions occur in healthcare, it is typical they show up in primary care settings, as well as in law enforcement and social services.

This can underscore the purpose of building and sustaining partnership among healthcare specialties and other disciplines to support public health and disasters.

One thing that is underreported, Morganstein said, is that the majority of people in a disaster situation will ultimately do well.

However, fear can often lead to a change in behaviors.

“Pandemics result in unique responses,” Morganstein said. “It's the perception of risk, not the actual risk that will ultimately determine how people behave.”

One way to reduce the mental health burden of the pandemic is to decrease media exposure about the disaster.

Morganstein said research shows increased exposure to disaster-related media increases insomnia, alcohol use, and the general stress of an individual.

Community leaders also play an important role in shaping response and behaviors.

Some suggestions for helping the public survive mentally through the pandemic included ensuring they are ready for the anticipated next wave and creating organization framework to address psychosocial risks.

“It's useful to remember the range of needs that people have and tailor the support we provide accordingly,” Morganstein said. “As with all disasters, the individual support need is significant.”

There are also plenty of options for individuals to access on their own to help with their mental health, including free psychological mobile applications, free online training, and community psychological first aid for supervisors and leaders.

Morganstein the stress is not lost on the frontline medical workers, where frustration, fatigue, and fear of the next wave are very common.

The impacts might particularly be bad in areas where mass deaths become commonplace.

The novelty of the experience, coupled with concerns over contamination likely amplify the stress, Morganstein said.

Similar to patients, doctors should also exhibit self-care practices, including regular sleep and meals, staying hydrated, exercising, and strengthen the immune system.

There is impact with the loss of routines and uncertainty about the future amplifies experiences in grief,” he said. “Studies of previous outbreaks highlight social and organizational factors that enhance that enhance psychological well-being of healthcare workers during infectious disease outbreaks.”